Amid continued high numbers of new infections, officials reported seven new deaths from COVID-19 in Alaska on Monday — the state announced five, and officials in Juneau and on the North Slope announced one each.
The state’s largest hospital, Providence Alaska Medical Center in Anchorage, announced last week it was shifting to crisis standards of care and rationing treatment due to a combination of staffing shortages and COVID-19 cases that accounted for about a third of the hospital’s patients.
It’s likely the hospital will remain in crisis mode for at least another two weeks “while we wait for this current surge to flatten and then dip back down,” chief of staff Dr. Kristen Solena Walkinshaw said in a media briefing Monday.
Providence decided to enact crisis standards on Sept. 11 as the hospital ran short on ventilation equipment -- mostly used by COVID-19 patients — as well as staff and machines needed for dialysis, according to Solena Walkinshaw.
A triage team using a specific formula to prioritize patients most likely to recover has been asked to help with several patient care decisions since then. Being vaccinated against COVID-19 is not part of the formula.
One person died who was unable to get the continuous renal replacement therapy they needed, she said. Four patients needed the therapy and only two could get it. The patient who survived without dialysis remains hospitalized in a palliative care setting.
Another decision involved deciding which patient got intubated because there weren’t enough beds in the ICU, where seriously ill COVID-19 patients often end up.
Another patient died at a rural hospital because they needed cardiac catheterization and was “waiting for a bed to free up so we could transfer them,” she said.
Providence set up a three-person wellness team to help doctors and nurses struggling with these kinds of decisions, as well as the rigors of dealing with younger, more severely ill COVID-19 patients including pregnant women, some of whom have died of the virus, Solena Walkinshaw said.
[Impossible choices inside Alaska’s inundated hospitals]
The current crisis is hitting ER and ICU doctors, and respiratory therapists, especially hard now, she said. Someone spat on a Providence resident as he left work. Families continue to deny that the virus is real even as they’re saying goodbye to their loved ones on a video call as they get taken off life support.
“Health care has become politicized and our entire country is polarized and there’s so much discordance around particularly COVID,” Solena Walkinshaw said. “Our health care workers feel incredibly unappreciated.”
The hospital’s emergency room was much less busy late last week, but ambulances keep coming and beds are still full, she said. “The scarcity is most severely felt in staffing. So, you know, we’re all pulling together. We have a lot of caregivers out themselves with either symptoms or COVID-positive right now.”
As Alaska’s COVID-19 surge continues, the state reported five new deaths from the virus, all in people in their 50s and 60s: Two Anchorage women in their 60s, a man from Anchor Point in his 60s, a woman from Homer in her 60s and a man from Sitka in his 50s.
Officials with the Arctic Slope Native Association on Monday reported the COVID-19 death of a North Slope resident. Juneau officials also reported the death of a man in his 50s at Bartlett Regional Hospital on Saturday.
[How do COVID-19 deaths in Alaska get counted?]
The number of people hospitalized with the coronavirus over the weekend dipped slightly from near-record levels. The decline in the hospitalization number reported Monday doesn’t necessarily signal a positive trend in Alaska’s surging COVID-19 rate, among the worst in the country, medical experts say.
State health officials say hospitalizations and deaths are lagging indicators that tend to follow high new-case reports by at least a week or two. Alaska reported new records for daily cases last week.
The situation in the state’s hospitals remained unchanged from last week, based on information provided Monday morning during a daily call the health department hosts for hospitals around the state, said Jared Kosin, president and CEO of the Alaska State Hospital and Nursing Home Association.
“There are still reports of exhaustion, lots of complex patients,” Kosin said. “It feels like we’re just in a bigger wave. We’re going to have our day-by-day ups and downs, but in terms of overall trends and how our facilities are feeling ... there’s no change.”
Even if infection rates start to drop, it will take time before there’s relief in hospitals, he said. “A few days of lower cases won’t translate to more stable in-patient environments for some time because of how intense of a level we’re all operating at right now.”
Providence physicians, in a letter to Alaskans, urged the public to get vaccinated and practice mitigations like masking. They also recommended avoiding “potentially dangerous activities.”
Other hospitals in Anchorage and elsewhere are delaying non-urgent surgeries and restricting visitors. Rural hospitals are struggling to transfer patients for higher-level care.
As reported by the state Monday, the number of COVID-positive patients hospitalized as of Sunday dropped below 200 to 198 after hitting a record of 210 earlier this month. Hospitals say those numbers are likely an undercount of the true impact of COVID-19, since they don’t include some long-term COVID-19 patients who no longer test positive but still need hospital care.
Washington state on Monday reported a more significant decline in hospitalization numbers, a change seen as partly a result of rising numbers of deaths in people with the virus.
Alaska on Monday also reported 2,054 new infections in residents in the three-day period from Friday to Sunday and another 54 nonresident cases, according to the Alaska Department of Health and Social Services dashboard. Resident case counts were 517 Sunday, 644 Saturday and 893 on Friday. Health officials say reporting backlogs make it hard to track real-time trends in cases.
As of Monday, 62.4% of Alaskans had received at least one dose of vaccine and 57.5% were fully vaccinated. Alaska ranked 32nd in the country for vaccination rates per 100,000.
The statewide seven-day rolling average for test positivity -- positive results out of total performed -- was 9.61% as of Monday. Health authorities say anything over 5% signals there’s not enough testing occurring.